This report is intended to serve as a reference for educators and service providers providing early intervention services and family support to children who have been prenatally substance exposed. The first two sections present information on the extent of the problem noting that 1,200,000 American women of reproductive age use cocaine, alcohol, marijuana, or nicotine in dangerous quantities. Prenatal and neonatal biological risk factors as well as maternal perinatal risk factors are then identified. The following section considers infant neurodevelopmental factors associated with substance abuse. A discussion of environmental risk factors follows including the importance of the postnatal social environment, families with multiple risks, children in foster care, and dysfunctional parent-infant units. Developmental outcomes and behavioral and learning characteristics of the child at risk due to substance exposure are then summarized. A major section considers service delivery issues. These include family centered service delivery, comprehensive coordinated interagency services, early identification of psychosocial and developmental risks, infant-family intervention services, and expanded preschool and elementary preventive education. The final section looks at California intervention programs and research including a "Program Model for Families with Infants and Toddlers Prenatally Substance Exposed," a kindergarten program for 4-year-olds at risk, and a study of educational needs of prenatally drug-exposed children. (Contains over 100 references.) (DB)